These results would support the concept that intraplaque neovascularization is associated with plaque instability and vulnerability and therefore, the use of CEUS could provide an additional non-invasive, simple, safe, and reliable imaging modality to stratify individuals risks. The identification of vulnerable and more progressive carotid lesions that are at increased risk of rupture and thrombosis by identification of intraplaque neovascularization is expected to improve the prediction of future vascular events and thus allow for better treatment selection. It will help the clinician to further risk stratify carotid stenosis. Particularly, it will help to identify unstable 50-69% carotid stenosis that may already benefit from invasive therapy as carotid endarterectomy and stenting, and may refrain patients from invasive therapy with stable >70% stenosis.